Post-Traumatic Headache After Mild Traumatic Brain Injury In A One-Year Follow Up Study – Risk Factors And Return To Work

Abstract Background: Post-traumatic headache (PTH) is a common symptom following mild traumatic brain injury (mTBI). Patients at risk to develop acute PTH (aPTH) and further persistent PTH (pPTH) need to be recognized. Methods: This is a one-year follow-up of 127 patients with mTBI, aged 18 to 68, referred to outpatient clinic in the Helsinki University Hospital. Symptoms were assessed at the emergency department (ED), with structured interview at outpatient clinic visit and with Rivermead post-concussion symptom questionnaire at one, three, and 12 months after injury. Psychiatric disorders were assessed with Structured Clinical Interview for DSM-IV Axis I disorders at 3-4 months and return to work (RTW) from patient records. Results: At one month, 77/127 patients (61%) had aPTH. According to multiple logistic regression analysis, risk factors for aPTH were headache at the emergency department (ED) (OR 5.43), other pain (OR 3.19), insomnia (OR 3.23), and vertigo (OR 5.98). At three months, 17 patients (22% of aPTH patients) had developed pPTH, and at one year, 4 patients (24% of pPTH patients) still presented with pPTH. Risk factors for pPTH at three months were older age (OR 1.06) and current insomnia (OR 12.3). The frequency of psychiatric disorders did not differ between the groups. pPTH patients performed worse on their RTW. Conclusions: Risk factors for aPTH were insomnia, headache at ED, other pain, and vertigo and for pPTH, insomnia and older age. RTW rate was lower among pPTH patients.

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The relationship between post-traumatic growth and return to work following mild traumatic brain injury

Disability and Rehabilitation ◽

10.1080/09638288.2018.1476598 ◽

2018 ◽

Vol 41 (22) ◽

pp. 2669-2675 ◽

Cited By ~ 2

Author(s):

Angela Sekely ◽

Konstantine K. Zakzanis

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Return To Work ◽

Mild Traumatic Brain Injury ◽

Post Traumatic Growth ◽

Post Traumatic ◽

The Relationship

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Clinical Predictors of 3- and 6-Month Outcome for Mild Traumatic Brain Injury Patients with a Negative Head CT Scan in the Emergency Department: A TRACK-TBI Pilot Study

Brain Sciences ◽

10.3390/brainsci10050269 ◽

2020 ◽

Vol 10 (5) ◽

pp. 269

Author(s):

Debbie Madhok ◽

John Yue ◽

Xiaoying Sun ◽

Catherine Suen ◽

Nathan Coss ◽

...

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Emergency Department ◽

Brain Injury ◽

Pilot Study ◽

Mild Traumatic Brain Injury ◽

Psychiatric History ◽

Clinical Predictors ◽

Head Ct ◽

Risk Patients

A considerable subset of mild traumatic brain injury (mTBI) patients fail to return to baseline functional status at or beyond 3 months postinjury. Identifying at-risk patients for poor outcome in the emergency department (ED) may improve surveillance strategies and referral to care. Subjects with mTBI (Glasgow Coma Scale 13–15) and negative ED initial head CT < 24 h of injury, completing 3- or 6-month functional outcome (Glasgow Outcome Scale-Extended; GOSE), were extracted from the prospective, multicenter Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot study. Outcomes were dichotomized to full recovery (GOSE = 8) vs. functional deficits (GOSE < 8). Univariate predictors with p < 0.10 were considered for multivariable regression. Adjusted odds ratios (AOR) were reported for outcome predictors. Significance was assessed at p < 0.05. Subjects who completed GOSE at 3- and 6-month were 211 (GOSE < 8: 60%) and 185 (GOSE < 8: 65%). Risk factors for 6-month GOSE < 8 included less education (AOR = 0.85 per-year increase, 95% CI: (0.74–0.98)), prior psychiatric history (AOR = 3.75 (1.73–8.12)), Asian/minority race (American Indian/Alaskan/Hawaiian/Pacific Islander) (AOR = 23.99 (2.93–196.84)), and Hispanic ethnicity (AOR = 3.48 (1.29–9.37)). Risk factors for 3-month GOSE < 8 were similar with the addition of injury by assault predicting poorer outcome (AOR = 3.53 (1.17–10.63)). In mTBI patients seen in urban trauma center EDs with negative CT, education, injury by assault, Asian/minority race, and prior psychiatric history emerged as risk factors for prolonged disability.

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Predictors for Return to Work in Subjects with Mild Traumatic Brain Injury

Behavioural Neurology ◽

10.1155/2016/8026414 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 17

Author(s):

Eirik Vikane ◽

Torgeir Hellstrøm ◽

Cecilie Røe ◽

Erik Bautz-Holter ◽

Jörg Aßmus ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Psychological Distress ◽

Brain Injury ◽

Sick Leave ◽

Return To Work ◽

Mild Traumatic Brain Injury ◽

Self Report ◽

University Hospitals ◽

Global Functioning ◽

One Year

Objective. To predict return to work (RTW) at 12 months for patients who either were sick-listed or were at risk to be sick-listed with persistent postconcussion symptoms (PCS) at six to eight weeks after injury.Method. A prospective cohort study of 151 patients with mild traumatic brain injury (MTBI) admitted consecutively to outpatient clinics at two University Hospitals in Norway. The study was conducted as part of a randomised clinical trial. Injury characteristics were obtained from the medical records. Sick leave data from one year before to one year after MTBI were obtained from the Norwegian Labour and Welfare Service. Self-report questionnaires were used to obtain demographic and symptom profiles.Results. We observed a significant negative association between RTW at 12 months and psychological distress, global functioning, and being sick-listed at two months after MTBI, as well as having been sick-listed the last year before injury.Conclusion. Psychological distress, global functioning postinjury, and the sick leave trajectory of the subjects were negative predictors for RTW. These findings should be taken into consideration when evaluating future vocational rehabilitation models.

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